The need for a change in medical research thinking. Eco-systemic research frames are better suited to explore patterned disease behaviors.

Many practicing physicians struggle to properly evaluate clinical research studies - they either simply do not know them, regard the reported findings as 'truth' since they were reported in a 'reputable' journal and blindly implement these interventions, or they disregard them as having little pragmatic impact or relevance to their daily clinical work. Three aspects for the latter are highlighted: study populations rarely reflect their practice population, the absolute average benefits on specific outcomes in most controlled studies, while statistically significant, are so small that they are pragmatically irrelevant, and overall mortality between the intervention and control groups are unaffected. These observations underscore the need to rethink our research approaches in the clinical context - moving from the predominant reductionist to an eco-systemic research approach will lead to knowledge better suited to clinical decision-making for an individual patient as it takes into account the complex interplay of multi-level variables that impact health outcomes in the real-world setting.

Life, complexity, and psychotherapy: A systemic perspective on the elusive construct of extra-therapeutic factors.

Study Aims: Despite being mentioned in well-known models of psychotherapeutic change, the concept of extra-therapeutic factors seems to have left the scene across time, eaten away by the progressive refinement of the construct of common factors. Aim of the present study is to better understanding the historical evolution of the concept of extra-therapeutic factors and its importance for psychotherapy today.

Methods: This is a position paper based on a literature review on extra-therapeutic factors and psychotherapy outcome and process.

A consulting room with a view: Psychotherapy and the ecological context.

Background: The field of psychotherapy is witnessing a lively debate today. The literature on the efficacy of psychological interventions has grown exponentially, but the assumptions of the prevailing research paradigms have been criticised from many points of view. One of the main concerns is that of a too often simplistic conception of psychotherapy, viewed as a set of specific methods for the treatment of point-like problems or symptoms.

A critical evaluation of choice negotiation for patient-centred medicine and psychotherapy.

Study Aims: The present paper aimed at discussing how the process of decision-making should be taken care of in healthcare services.

Methods: This is a position paper based on a review of the relevant literature about meaning-making processes in medical encounters and psychotherapy.

Discussion: Authors argued that choice options could be perceived as meaningful by patients if their uncertainties were taken into account and grounded on mutual understanding and reciprocal trust.

Methods for informing people with amyotrophic lateral sclerosis/motor neuron disease of their diagnosis.

Background: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), causes increasing physical impairment and disability. People with ALS/MND face huge physical challenges, and the diagnosis can be a source of great psychological distress for both people with ALS/MND and their carers. In such a context, how news of the diagnosis is broken is important.